F07.81 — Postconcussional syndrome
F07.81 is a billable, specific ICD-10-CM code for postconcussional syndrome. It is valid for submission on a claim.
Excludes1 — never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
Use additional code
Add a secondary code to capture the detail described below.
- code to identify associated post-traumatic headache, if applicable (G44.3-)
Code also
Both codes may be needed to describe the encounter fully. Sequencing depends on the reason for the visit.
- , if applicable, sequela of concussion (S06.0X- with seventh character S)
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Postcontusional syndrome (encephalopathy)
- Post-traumatic brain syndrome, nonpsychotic
Other codes that can never be billed with F07.81
These codes carry an Excludes1 note pointing at F07.81. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading F07.81 alone.
- F07.0Personality change due to known physiological condition
Risk adjustment
F07.81 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Medicare coverage
F07.81 is named in 13 Medicare coverage policies — 12 listing it as supporting medical necessity, and 1 listing it as NOT covered. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A52434Health and Behavior Assessment/Intervention – Medical Policy Articlenot covered
- A56551Billing and Coding: Visual Fields Testing
- A56612Billing and Coding: CT of the Head
- A56799Billing and Coding: Visual Fields Testing
How F07.81 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to F07.81.
- Encephalosis, posttraumatic
- Post-traumatic brain syndrome, nonpsychotic
- Postconcussional syndrome
- Postcontusional syndrome
- Punch drunk
- Concussion›syndrome
- Disorder›postconcussional
- Encephalopathy›postcontusional
- Encephalopathy›traumatic(postconcussional)
- Psychopathy, psychopathic›constitution, post-traumatic
- Status›postcommotio cerebri
- Syndrome›concussion
Related codes at this level
Codes that share F07.8. If F07.81 is not quite right, the correct code is usually one of these.
Questions about F07.81
- Is F07.81 a billable ICD-10-CM code?
- Yes. F07.81 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does F07.81 sit in the tabular list?
- Mental, Behavioral and Neurodevelopmental disorders (F01-F99), in the block Mental disorders due to known physiological conditions (F01-F09).
- What cannot be coded together with F07.81?
- F07.81 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.